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Steele, James. (2013). Intensity; in-ten-si-ty; noun. 1.

OIten used ambiguously within resistane


training. 2. Is it time to drop the term altogether Intensity; in-ten-si-ty; noun. 1. OIten used
ambiguously within resistane training. 2. Is it time to drop the term altogether, 12 February 2013,
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Intensity; in-ten-si-ty; noun. 1. Often used
ambiguously within resistance training. 2. Is it time
to drop the term altogether?
James Steele
Correspondence to
James Steele, Centre for
Health, Exercise and Sport
Science, Southampton Solent
University, Southampton SO14
0YN, UK;
james.steele@solent.ac.uk
Received 21 December 2012
Revised 21 December 2013
Accepted 19 January 2013
To cite: Steele J. Br J Sports
Med Published Online First:
[ please include Day Month
Year] doi:10.1136/bjsports-
2012-092127
INTRODUCTION
Recently in BJSM, Dr Berkoff
1
highlighted some
hot topics in sports and exercise medicine.
A variety of topics were covered, all of which were
hot. Of particular interest, however, was the fact
that Dr Berkoff preceded his article with a den-
ition of hot. Within sports and exercise medicine,
and indeed in all scientic disciplines, denitions
are of great importance. In fact, The primary
advantage of operational denitions lies in the uni-
cation of science and the resolution of contro-
versy.
2
It is the denition and use of a term within
a topic that might also be deemed as hot that this
editorial attempts to address: Intensity in resistance
training (RT).
Recent publications regarding RT have attempted
to offer clarication on the denition of intensity.
3 4
Fisher and Smith
3
wrote regarding the use of the
term intensity within RT suggesting that it is better
representative of effort, whereas other authors have
considered it synonymous with load.
4
Fisher and
Smith
2
are not the rst to suggest that the use of
intensity to refer to load in RT is inappropriate.
Others have previously attempted to instigate a
change in the language used by researchers and
practitioners.
5 6
Despite previously nding myself
supporting this view (that intensity is better dened
as effort and not load) regarding the use of the
term and having published as such,
6 7
further con-
sideration has left me doubting the value of both
interpretation of intensity as synonymous with load
or effort. Thus, this editorial seeks to ask the
readers of BJSM, and the wider community
involved in RT, to consider the use of the term
intensity as it stands and whether both sides of the
disagreement are defending inappropriate idioms.
More specically, however, it asks, Is it time to
drop the term altogether?
IS INTENSITY A LOAD OR AN EFFORT?
As mentioned, in previous publications I have sup-
ported the view that intensity is representative of
effort and not of load.
6 7
The crux of the argument
for why intensity does not represent load in RT,
and why intensity should instead be considered as a
representative of effort is as follows.
3 4
The use of
load implies that two individuals performing the
same number of repetitions at the same relative
load are working at the same intensity. However,
research shows that maximal repetition ranges at
relative loads can vary considerably between indivi-
duals
8 9
and so considering load may not offer an
appropriate means of understanding the effort put
forth during resistance exercise. Based upon these
considerations, only one accurate control of effort
is possible during specic RT, that of 100%, that is,
when the participant reaches maximal effort or
momentary muscular failure (MMF).
5 6 810
For
example, assuming two persons one repetition
maximum (1 RM) is 100 kg and load was consid-
ered as a representative of intensity, if one individ-
ual performs an exercise with a load of 80 kg (80%
1 RM), and performs one easy repetition with that
load, this person is training more intensely than
another individual who performs a hard set to
MMF with 79 kg (79% 1 RM).
4
Shimano et al,
9
however, showed that rating of perceived exertion
(RPE) is similar regardless of load when repetitions
are taken to MMF.
Yet, a further part of the argument also made by
Fisher and Smith
3
against the use of intensity to
refer to the load used during RT was against the
fact that others consider it the common under-
standing and usage of the term in practice.
11 12
It
has occurred to me that I and my fellow colleagues
have also been following a similar idiom as
others
11 12
with the use of intensity to refer to
effort. For example, Fisher and Smith
3
suggest that
Within the area of cardiovascular or aerobic exer-
cise, intensity is generally considered to represent
the effort required by the body, the issue here
being that, although within that particular modality
of exercise, intensity is commonly considered syn-
onymous with effort, this does not necessarily
imply that it is being used correctly in that instance
either. For example, Fisher and Smith
1
highlight
that it is often represented as a percentage relative
to maximum heart rate (HR). However, HR can
signicantly change in the absence of physical
effort from exercise as shown by the signicant
increases seen in preparing for and engaging in psy-
chologically stressful situations,
13
suggesting that
the two are not synonymous even within cardiovas-
cular exercise.
INTENSITY PROPERLY DEFINED AND USED
The Oxford English Dictionary
14
offers as a den-
ition for the term intensity, The degree or
amount of some quality, condition, etc; force,
strength, energy; degree of some characteristic
quality, as brightness, etc; especially, in physics, as a
measurable quantity. A consideration of this den-
ition suggests that I, my fellow colleagues and the
rest of the sport and exercise medicine community
involved in RT and exercise as a whole are using
the term intensity incorrectly. More precisely, inten-
sity should be used only in one context (and
perhaps that should even be avoided altogether for
Steele J. Br J Sports Med 2013;00:13. doi:10.1136/bjsports-2012-092127 1
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the sake of clarity). That context is when stating or asking a
question regarding the intensity OF something relative to a
maximal value. As the dictionary denition suggests, intensity
concerns the magnitude or degree of some measureable quan-
tity. Thus, in cardiovascular exercise, it would be more appro-
priate to speak of the intensity OF velocity/incline/resistance, etc
during exercise and measure the intensity OF heart rate/blood
lactate/oxygen uptake, etc. In RT, we could talk of the intensity
OF load as being the percentage of 1 RM or maximum volun-
tary contraction that is being used. Or we might talk of the
intensity OF effort involved during an exercise with the caveat
that we can only gain subjective measurement of the sense of
effort through RPE, and measurement of motor unit (MU)
recruitment in RT provides a physiological variable correlating
with effort, with max MU recruitment representing max effort
independent of load.
10 15
Along this vein of thought, however, we might also consider
the differentiation between sense of effort and the physical sen-
sations associated with exercise, which, considering the above
denition of intensity, would also be inappropriately labelled as
such. Indeed, these phenomena have also been recently called
upon to be differentiated appropriately within the articles pub-
lished in BJSM.
16 17
Smirmaul
16
offers a practical example
appropriate to RT in this regard suggesting, A short maximal
voluntary contraction for leg extension, for example, will
induce a maximal sense of effort while, initially, other unpleas-
ant sensations will probably be modest. Repeating this maximal
contraction several times, however, will increase these unpleas-
ant sensations continuously, whereas sense of effort will always
be the same (ie, maximal). Indeed, I and my colleagues have
questioned the use of RPE in RT to determine relative effort.
6
Shimano et al
9
showed that, when repetitions were continued to
MMF, RPE was similar at 60%, 80% and 90% of 1 RM for
most exercises; however, RPE was signicantly higher during
60% 1 RM squat performed to MMF. Effort would have been
maximal between conditions considering they were continued
to MMF, and thus the different RPE during 60% 1 RM squats
may be an artefact of the measure constituting both sense of
effort and the physical sensations associated with the longer dur-
ation of RT performed for the legs. Perhaps the use of tools
such as those suggested by Swart et al
17
to differentiate these
two distinct phenomena should also be applied to future RT
research. Yet in spite of this, and practically speaking, in order
to appropriately control effort in order to examine the impact
of other RT variables on these distinct phenomena, only one
way of controlling effort in research exists and that is having a
participant train maximally irrespective of load, that is, to
MMF.
6
CONFUSION IS BORNE FROM AMBIGUITY
As an example of the confusion that an imprecise use of the term
intensity can cause while drawing conclusions from research, espe-
cially with regard to understanding the impact of load or effort, I
refer to a recent article published in BJSM.
18
Kristensen and
Franklyn-Miller
18
conducted a systematic review of the use of RT
in musculoskeletal rehabilitation in a valuable attempt to provide
guidelines as to the optimal manipulation of RT variables for use
in populations with musculoskeletal disorders. As such, one of the
variables they considered in their interpretation of the studies was
intensity. One of the musculoskeletal conditions reviewed was
chronic low back pain, and two of the studies reviewed claimed to
compare what were termed high intensity training (HIT) and
low intensity training (LIT) with each other
19
and also with a
waiting list control group.
20
However, despite intensity being the
variable of interest in these studies, no denition of the same was
offered, and as such, difculty is rendered in drawing rm conclu-
sions from the results of both. The manner in which Helmhout
et al
19
appear to have dened intensity within this study in fact
refers to load, and as such, the result was that relative effort was
not controlled. Training for the HIT group in the rst study
19
involved 1520 repetitions during weeks 1 and 2, and 1015 repe-
titions between weeks 3 and 12, with a load equal to 35% of the
participants maximal isometric lumbar extension strength. Once
the participant could complete more than the maximum number
of repetitions, the load was increased by 2.5 kg (no indication of
whether the participants were encouraged to continue repetitions
past the maximum required when able to, ie, to MMF, was speci-
ed). In contrast, the LIT group performed 15 repetitions during
the rst and second weeks after each test, and 20 repetitions
during the 3rd and 4th week after each test using only 20% of
their maximal lumbar extension strength as measured in week
1. In the second study, Harts et al
20
utilised the same programme
but increased the load used by the HIT group to 50% of their
maximal lumbar extension strength while keeping the LIT groups
load the same as previously.
Kristensen and Franklyn-Miller
18
commented that in
both these above studies, the denition of high-intensity RTwas
different to the conventional denition of high-intensity RT in a
healthy population. Kristensen and Franklyn-Miller appear to
be considering the denition of intensity as load as they note
that exercise intensity of >70% of 1RM. can be classied as
high-intensity. They also suggest that it is unsurprising that
there were no signicant adaptations in either of the groups as
both were training at a low intensity (of load). However, it is
unclear whether the low loads used in these studies were indeed
responsible for the lack of adaptations and this confusion stems
from the use of terminology in the two original studies exam-
ined. The intensity OF load used by the groups in the
studies
19 20
did indeed differ. But as it is unclear whether either
of the groups is trained to MMF, it is likely that intensity OF
effort also differed and it impossible to know to what degree
effort (and thus perhaps also MU recruitment
10 15
) may have
differed between them. Effort will increase with an increase in
load assuming all other variables are held constant, yet the loads
used in these studies and the degree of difference between
groups was rather small (HITused 35/50% of max strength, LIT
used 20% of max strength). In fact, the LIT group may have
trained at a relative load similar to the HIT group as the authors
noted that even the lowest load that could be used on the
lumbar extension machine could not be set low enough to
achieve 20% in some participants. In considering the typical
repetition ranges that are possible at different loads relative to
maximal strength,
8 9
and the repetition ranges used within this
study, it would be more appropriate to conclude that both
groups in fact were trained at what could be considered a low
intensity of both load and effort. Because the appropriate appli-
cation of both load and effort may have importance for produ-
cing optimal adaptations, it is perhaps not surprising that the
studies found very little differences between both the HIT and
LIT groups.
CONCLUSION AND A PLEA TO PEERS
To conclude this editorial, I hope that I have opened up a con-
sideration of the appropriate use of the term intensity in the
minds of the BJSM readers, and I would urge all those involved
in RT to consider their current use of the term intensity.
Intensity refers to the degree or magnitude of a measurable
characteristic or variable. If it is not being used in terms of the
2 Steele J. Br J Sports Med 2013;00:13. doi:10.1136/bjsports-2012-092127
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group.bmj.com on February 13, 2013 - Published by bjsm.bmj.com Downloaded from
exact denition offered by the Oxford English Dictionary, it
should be claried in the instance used, for example, if it is
being used as synonymous with load or effort being that they
are the terms most commonly considered. However, despite
probably being an unfavourable recommendation for some,
I think more appropriate would be the withdrawal of the term
altogether. Greater clarity or withdrawal of use of the term
would result in far greater lucidity for researchers, practitioners
and recreational exercisers alike in reading and interpreting the
studies conducted, which often can be a guessing game in this
regard as to whether they offer insight as to the optimal
manipulation of load or effort. Appropriate use of this term is
something I will personally be striving to achieve in any further
publications in order to make interpretation of my work by my
colleagues and peers easier, and I offer my apologies for any
misunderstanding caused by my previous work in which,
although I have claried intensity in reference to effort, the use
of the term was inappropriate nonetheless.
6 7
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.
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doi: 10.1136/bjsports-2012-092127
published online February 12, 2013 Br J Sports Med

James Steele

it time to drop the term altogether?


Is ambiguously within resistance training. 2.
. 1. Often used noun ; in-ten-si-ty; Intensity
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